Acute Behavioral Health Services - Adult

Emergency Service Interventions are 24 hours a day, 7 days a week, face-to-face care management and intervention of an individual experiencing a behavioral health crisis. Such crisis includes an imminent, real, and significant risk of serious harm to self or others that requires immediate treatment. The activities are conducted by a licensed behavioral health provider in a hospital emergency room, residential placement setting, the individual’s home, police station or other community setting that the family and the child-family competent clinician agree is safe and clinically suitable to resolve the behavioral health crisis. The provider ensures that each member’s aftercare/discharge plan will be shared with the member’s primary care provider within three (3) business days of the emergency room discharge (if the member is not admitted to inpatient level of care).

A secure and protected, medically staffed, psychiatrically supervised program designed for those members who, as a result of psychiatric disorder, are an acute and significant danger to themselves or others, or who are acutely and significantly disabled and cannot meet their basic needs and functions, and who require extended observation and treatment in order to determine the most appropriate level of care and to avoid acute inpatient hospitalization.

Services provided in a hospital with an acute psychiatric unit, or freestanding detoxification facility staffed by license physicians (including psychiatrists) with 24-hour skilled nursing in a structure treatment milieu for the treatment of members with a mental health or substance use disorder of sudden onset and short, severe course who cannot be safely or effectively treated in a less intensive level of care.

A community based short-term service or hospital step-down that provides comprehensive multidisciplinary behavioral health evaluation and treatment in a staff setting offering high levels of supervision, structure, restrictiveness and intense treatment on a 24-hour basis. The treatment should include individual, family, and group clinical therapy, crisis management, and medical evaluation and management.

Provide a planned and structured regimen of 24-hour professionally directed evaluation, observation, medical monitoring, and addiction treatment in an inpatient setting.